Stricter vigilance and fewer transfusions are the way forward

Until recently it seemed that the United Kingdom's blood services could maintain continuous improvement in blood safety by the progressive introduction of extra screening tests and new procedures. These would, it was hoped, minimise the risk of bloodborne infection without the ongoing supply of volunteer donors' blood being compromised. Today that hope seems vain unless some decisive actions are taken. Not only does allogeneic blood continue to carry general microbial and immunological risks that can never be entirely eliminated, but also there is no way at present to deal with the possibility that a proportion of blood donors in the United Kingdom may turn out to transmit variant Creutzfeldt-Jakob disease. No current test can identify that risk. Even if such a test were to be devised, the time needed to evaluate its specificity, sensitivity, and acceptability would mean that many months, possibly several years, would separate its discovery from its routine application; and once applied it might put great strains on blood procurement in United Kingdom.

The risk of Creutzfeldt-Jakob disease, discussed widely in medical journals and in the lay press,1 remains notional, and so far no evidence exists that either the classical or the variant form of the disease can be transmitted by transfusion. Nevertheless, experiments with the bovine spongiform encephalopathy agent in sheep and mice show that …